459例Ⅳ期非小细胞肺癌放疗生存分析  

Survival Analysis of 459 Cases with Non-small Cell Lung Cancer Stage Ⅳ After Radiotherapy

作　　者：李芳娟[1] 刘辉[1] 毛翎[1] 吴琼雅[1] 吴红宇[1] 蔡勇[1] 刘宇[1] 孙希文[1] 

机构地区：[1]同济大学附属上海市肺科医院,上海200433

出　　处：《肿瘤学杂志》2013年第6期435-438,共4页Journal of Chinese Oncology

摘　　要：[目的]分析放疗对于Ⅳ期非小细胞肺癌(NSCLC)患者预后的影响。[方法]对459例接受放疗的Ⅳ期NSCLC患者资料进行回顾性分析。放疗均采用6/10MVX线直线加速器,全脑和骨放疗为2周10次共30Gy的分割方案。原发灶、区域淋巴结中位放疗剂量为52Gy(25～66Gy)。[结果]459例患者中位生存期10.7个月。1、2、3、4、5年生存率分别为43%、17%、8%、5%、3%。年龄<70岁较年龄≥70岁的中位生存期长(11.4个月与9.0个月,P=0.043)。单器官转移比多器官转移的中位生存期长(10.9个月与8.6个月,P=0.017)。有无脑转移的中位生存期为9.6个月与11.4个月(P<0.001)。化疗比未化疗的中位生存期长(10.9个月与8.6个月,P=0.011)。原发灶放疗比未行原发灶放疗的中位生存期长(10.9个月与10.3个月,P=0.047)。性别、病理类型对生存未见显著影响。[结论]年龄、是否脑转移、转移器官数目、是否化疗及是否原发灶放疗对Ⅳ期NSCLC放疗后生存有显著影响。Purpose To investigate the influence in radiotherapy on prognosis in patients with non-small cell lung cancer （NSCLC） stage Ⅳ . Methods Clinical data of 459 patients with NSCLC stage Ⅳ treated with radiotherapy were analyzed retrospectively. Radiotherapy was carried out by linear accelerator （6/10MV X-ray）. Whole brain and bone radiotherapy were delivered with a total of 30Gy in 10 fractions for 2 weeks. The median dose for primary tumors and regional lymph nodes was 52Gy （25～66Gy）.Results The median survival of the 459 patients was 10.7 months. The 1-,2-,3-,4- and 5-year overall survival rates were 43% ,17% ,8% ,5% and 3% respectively.The median survival was longer in the patients 70 years old than that in those ≥70 years old （11.4 months vs 9.0 months,P=0.043）,and longer in patients with single organ metastasis than that in patients with multiple organ metastasis （10.9 months vs 8.6 months,P =0.017）.The median survival of patients with and without brain metastasis were 9.6 months and 11.4 months respectively （P0.001）.The median survival was longer in the patients with chemotherapy than that in the patients without （10.9 months vs 8.6 months ,P=0.011）,and longer in the patients with radiotherapy for primary tumors than that in the patients without（10.9 months vs 10.3 months,P=0.047）. Gender and pathological types had no significant influence on survival.Conclusion Patient’s age,brain metastasis,number of metastatic organ,chemotherapy and radiotherapy for primary tumors may affect the survival in patients with NSCLC stage Ⅳ postradiotherapy.

关 键 词：肺肿瘤 癌 非小细胞肺 放射疗法 预后 

分 类 号：R734.2[医药卫生—肿瘤]